Perceived Workplace Supports and Work-Related Wellbeing In a National Sample of Obstetrician-Gynecologists

Background and Purpose: Obstetrician-gynecologists (OB-GYNs) may experience greater stress and associated mental health symptoms following the U.S. Supreme Court’s 2022 Dobbs v. Jackson decision, allowing states to impose total or near-total bans on abortion, and to impose criminal and civil penalties for providers found in violation of the laws. Organization-level supportive practices are a promising target for improving physician mental health and wellbeing because they intervene on mental health risk factors, rather than trying to treat or mitigate mental health problems once they have already occurred. The objective of this study was to analyze the extent to which, in a national survey sample of OB-GYNs from the full range of abortion policy climates, providers’ perceptions of multiple forms of support from their institution were associated with mental health outcomes.

Methods: Participants were recruited for an online survey by a physician market research firm. Inclusion criteria were attending OB-GYNs, practicing in the United States, either a general OB-GYN or a subspecialist in maternal-fetal medicine or complex family planning, and providing care to pregnant patients. We included three measures of mental health and work-related wellbeing: anxiety (GAD-2), depression (PHQ-2), and burnout (Stanford Professional Fulfillment Index). We categorized participants’ state abortion policy environment as restrictive or protective according to the Guttmacher Institute’s abortion policy tracker. We assessed the extent to which participants felt supported by their legal team; supported by their non-OB-GYN health professional colleagues; supported by their department chair; their perception that their hospital supported them on legal matters; and perception that institutional leaders understood the challenges of being an OB-GYN in 2025. Using logistic regression, we examined the relationship between institutional support and depression, anxiety, and burnout within our sample.

Results: We received survey responses from 864 OB-GYNs, from 49 U.S. states plus D.C. Of these, 566 (66%) were from states classified as abortion-restrictive and 298 (34%) were from states classified as abortion-protective. Across policy environments, of the five supports measured, the most highly endorsed support was “My chief or chair supports my clinical judgment” (72% very much agreed). For each of the three outcomes of interest—depression, anxiety, and burnout—decreasing level of reporting each type of institutional support was associated with greater odds of experiencing that outcome. For example, for burnout, compared with those who very much agreed that their institution’s legal department supported their clinical judgment, those who somewhat agreed had odds of burnout of 1.37 (95% CI 1.01, 1.85) and those who did not at all agree had odds of burnout of 2.73 (95% CI 1.44, 5.17). Furthermore, across all institutional supports, those who reported not at all receiving that form of support had significantly elevated (p<0.05) odds of experiencing each of the three mental health outcomes.

Discussion: We observed consistent associations between lower perceptions of organization-level support and higher rates of depression, anxiety, and burnout. These patterns held in both abortion-protective and abortion-restrictive states. Findings have implications for organization-level policies and practices that enhance support to improve physician mental health and wellbeing across all policy environments.